The Pancoast tumor is an uncommon type of lung cancer that arises from within the superior sulcus. With most clinical manifestations occurring due to mass effect, Pancoast syndrome is a known complication that includes shoulder and arm musculoskeletal pain, Horner's syndrome and neurological complications of the upper extremities, including weakness and atrophy. Even though adenocarcinoma is the most common cause of Pancoast syndrome among lung cancers, other malignancies can be responsible as well. Treatment is similar to that of other standard NSCLC treatments that include chemotherapy, radiation, immunotherapy and surgery. Here we report a patient with Pancoast syndrome secondary to a poorly differentiated malignant neoplasm composed of anaplastic cells.

The dissemination of Computed Tomography (CT) scan has promoted a significant increase in the absorbed dose by patients due to the diagnosis. Therefore, it is indispensable to improve protocols, seeking smaller doses, without impairing the diagnostic quality of the image. The risks of stochastic effects are greater for children due to tissue radiosensitivity coupled with longer life expectancy. In this work, a cylindrical phantom made of polymethylmethacrylate was used representing an adult chest, and a second phantom made of the same material was designed in an oblong shape, including axillary region, based on the dimensions of an eight-year-old pediatric patient. A comparative study was performed between chest scans formulated in two CT scanners in different radiodiagnostic services. The central slice of the both phantoms was irradiated successively, using a pencil ionization chamber, for the measurements in five different spots of each phantom. From the measurements, we obtained values of weighted and volumetric Dose Index (C vol ). The scans were performed with the routine chest acquisition protocols of the radiodiagnostic services, both for a voltage of 120 kV X-ray tube supply voltage. This work allowed to compare the dose between patients with variable chest volumes and the dose variation in patients between two CT scanners used for image generation with the same diagnostic objective.

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